Appendix A - Data Elements for 155 Subpart C

CMS-10490 - Appendix A_Data_Elements for Part 155 Subpart C.PDF

Program Integrity and Additional State Information Collections

Appendix A - Data Elements for 155 Subpart C

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Appendix A: Data Elements for General Function of an Exchange (Part 155, Subpart C)
The data elements for the collections of information included in Part 155, Subpart C– General
Function of an Exchange, are as follows:
Ability of States to Permit Agents and Brokers to Assist Qualified Individuals, Qualified
Employers, or Qualified Employees Enrolling in Qualified Health Plans in the Federallyfacilitated Exchange (§155.220)
Proposed §155.220(g) describes the process for HHS to terminate and agent’s or broker’s
agreement with the Federally-facilitated Exchange for cause. HHS will notify the agent or
broker of the specific finding of noncompliance or pattern of noncompliance. We assume the
agent or broker may acknowledge receipt of this notice by providing a written statement that
includes the following issuer information:
1.
2.
3.
4.
5.

Agent or broker name
Agent or broker address
Date of receipt of notice
Date of submission of acknowledgement
Type of notice received

Proposed §155.220(h) explains how an agent or broker whose agreement has been terminated
can request a reconsideration of such action. The agent or broker must submit a written request
within 30 calendar days of the date of the written notice from HHS. No information is given as to
what the request should contain; it is our assumption that the request needs to contain all the
information necessary for the agent or broker to explain their situation and receive a favorable
response from the reconsideration entity. This information may include the following:
1.
2.
3.
4.
5.
6.

Agent or broker name
Agent or broker address
Date of receipt of notice
Date of submission of request
Type of notice received
Evidence to counteract any specific details specified in the notice from HHS that give
grounds for terminating the agreement, and explanation for why the agreement should not
be terminated
7. Evidence that shows the agent or broker’s overall financial and regulatory good standing

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File Typeapplication/pdf
AuthorRickenbach, Jessica [USA]
File Modified2013-06-28
File Created2013-06-28

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